Provider Demographics
NPI:1245477652
Name:HSU, YUNG-SHEE JESSICA (MD, MBA)
Entity type:Individual
Prefix:
First Name:YUNG-SHEE
Middle Name:JESSICA
Last Name:HSU
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:HSU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MBA
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-794-7274
Mailing Address - Fax:
Practice Address - Street 1:1245 16TH ST
Practice Address - Street 2:202
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1235
Practice Address - Country:US
Practice Address - Phone:310-301-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111465207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A1114650Medicaid
CAGF221ZMedicare PIN